Reference Values for Noninvasive Blood Pressure in Children during Anesthesia: A Multicentered Retrospective Observational Cohort Study

Jurgen C de Graaff, Wietze Pasma, Stef van Buuren, Jesse J Duijghuisen, Olubukola O Nafiu, Sachin Kheterpal, Wilton A van Klei, Jurgen C de Graaff, Wietze Pasma, Stef van Buuren, Jesse J Duijghuisen, Olubukola O Nafiu, Sachin Kheterpal, Wilton A van Klei

Abstract

Background: Although noninvasive blood pressure (NIBP) monitoring during anesthesia is a standard of care, reference ranges for blood pressure in anesthetized children are not available. We developed sex- and age-specific reference ranges for NIBP in children during anesthesia and surgery.

Methods: In this retrospective observational cohort study, we included NIBP data of children with no or mild comorbidity younger than 18 yr old from the Multicenter Perioperative Outcomes Group data set. Sex-specific percentiles of the NIBP values for age were developed and extrapolated into diagrams and reference tables representing the 50th percentile (0 SD), +1 SD, -1 SD, and the upper (+2 SD) and lower reference ranges (-2 SD).

Results: In total, 116,362 cases from 10 centers were available for the construction of NIBP age- and sex-specific reference curves. The 0 SD of the mean NIBP during anesthesia varied from 33 mmHg at birth to 67 mmHg at 18 yr. The low cutoff NIBP (2 SD below the 50th percentile) varied from 17 mmHg at birth to 47 mmHg at 18 yr old.

Conclusions: This is the first study to present reference ranges for blood pressure in children during anesthesia. These reference ranges based on the variation of values obtained in daily care in children during anesthesia could be used for rapid screening of changes in blood pressure during anesthesia and may provide a consistent reference for future blood pressure-related pediatric anesthesia research.

Figures

Fig. 1
Fig. 1
Flow diagram of data inclusion from Multicenter Perioperative Outcomes Group data set.
Fig. 2
Fig. 2
Reference curves for noninvasive blood pressure for boys and girls during anesthesia during the preparation phase in relation to age.
Fig. 3
Fig. 3
Reference curves for noninvasive blood pressure for boys and girls during anesthesia during the surgical phase in relation to age.
Fig. 4
Fig. 4
Reference curves for noninvasive blood pressure for boys and girls during anesthesia during the preparation phase in relation to weight.
Fig. 5
Fig. 5
Reference curves for noninvasive blood pressure for boys and girls during anesthesia during the surgical phase in relation to weight.

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